Study finds freestanding EDs charge more than urgent care centers

Freestanding emergency departments (FSEDs) may charge more than urgent care centers (UCCs) to provide care for fewer patients who have similar characteristics and conditions, according to a study released in the Journal of Emergency Medicine.

FSEDs are Emergency Departments that are not attached to an acute care hospital and may either be independent or affiliated with a hospital. FSEDs have experienced significant growth in certain states over the past decade.

After researching the conversion of three UCCs to independent FSEDs in Texas using insurance claims from Blue Cross Blue Shield of Texas, results show annual patient volume decreased between 29.5 percent and 94.8 percent, and reimbursement per visit increased between 970 percent and 1,369 percent, according to first author, Sabrina J. Poon, MD, instructor of Emergency Medicine at Vanderbilt University Medical Center.

"This study highlights some of the payment reimbursement structures that are not ideally suited to the patient or to our health care system as a whole. While this is a case study of three facilities and is not generalizable to all FSEDs, this study shines a light on these reimbursement structures and how they can potentially be used to increase revenue," said Poon, who took part in this study while completing a fellowship in Emergency Medicine Health Policy Research and Translation at Brigham and Women's Hospital at Harvard Medical School.

A goal of this study was to find whether FSEDs are more similar to higher-cost hospital-based EDs or to lower-cost UCCs.

When combining data for the three FSEDs in Texas, the research shows no significant difference in the age or gender of the patients and little difference in conditions managed at both the UCC and FSED.

However, researchers found a small increase in patient visits for potentially more severe conditions such as chest pain, which accounted for 0.5 percent of UCC visits, then rose to 2.3 percent of FSED visits.

"You have to look at why patients are going to FSEDs, as there are benefits. They are convenient, they are located in a place that is easy to get to, there is a shorter wait time, and the list of services or care provided is what patients are looking for. The question is, how can we provide this care in the most valuable way for both patients and the health care system?" said Poon.

-end-

Tennessee currently has seven FSEDs, five of those within the Middle Tennessee area. Two more FSEDs have been approved.

Tweeting in times of emergencyUS researchers have assessed the impact of Twitter on the reach and efficacy of information sharing by a global disaster response organization, the Red Cross/Red Crescent.

Elder abuse under-identified in US emergency departmentsIn a new study published this week in the Journal of the American Geriatrics Society, researchers used a nationally-representative dataset to estimate the frequency with which emergency providers make a formal diagnosis of elder abuse.

Educational debt for emergency medicine bigger than average mortgageThe average educational debt carried by emergency medicine residents is approximately 25 percent higher than the average mortgage in the United States, according to the results of a study published online last Thursday in Annals of Emergency Medicine, and has profound effects on their career and life choices ('Impact of Educational Debt on Emergency Medicine Residents: A Qualitative Study Employing Individual Interview').

Best Science Podcasts 2019

SetbacksFailure can feel lonely and final. But can we learn from failure, even reframe it, to feel more like a temporary setback? This hour, TED speakers on changing a crushing defeat into a stepping stone. Guests include entrepreneur Leticia Gasca, psychology professor Alison Ledgerwood, astronomer Phil Plait, former professional athlete Charly Haversat, and UPS training manager Jon Bowers.

#524 The Human NetworkWhat does a network of humans look like and how does it work? How does information spread? How do decisions and opinions spread? What gets distorted as it moves through the network and why? This week we dig into the ins and outs of human networks with Matthew Jackson, Professor of Economics at Stanford University and author of the book "The Human Network: How Your Social Position Determines Your Power, Beliefs, and Behaviours".